progressive collaborative management experience, David has produced measurable results to improve the lives of children, adults and families

with behavioral health needs.

Jones possesses a vast in-depth knowledge of state and federal

regulations inclusive of Medicaid managed care and Mental Health Rehabilitation Standards. He has managed both an urban and suburban public behavioral health system that achieved outcomes inclusive of increasing access to care and expanding the range of services

available to residents with behavioral health care needs.

As the appointed Chief of Behavioral Health and Crisis Services with Maryland’s Montgomery County Department of Health and Human

Jones earned a Master's Degree in Community School/Clinical Child Psychology from Southern Illinois University-Edwardsville and partially completed the requirements for a Master’s of Health Services Administration at George Washington University.

David said that he has now been in a Deputy Commissioner for a little over three years and that when he first heard about the Consumer Satisfaction Team, he thought it was a “remarkable” idea.

He relayed that he has worked in a number of different states and he has had an opportunity to see a lot of good work being done around behavioral health. However, he said that Philadelphia was the only place that he had ever seen an agency staffed entirely with people or family members of people with lived experience speaking with current behavioral health service recipients about the quality of their interaction with the system and what could make it better.

He said that what makes the biggest difference is that the information is the most objective feedback that the system could receive. He added that if this information were collected by employees of DBHIDS, there would be an inherit bias in both how the questions would be asked and how folks would respond.

He said that given the way the CST model operates it is a remarkable way to assess the system.

Over the last three years that he has been here, he feels that CST had the most impact on helping the system develop more community based services as opposed to relying on more institutional care. He said that based on the way CST relays information it has paved the way to encourage DBHIDS to look at how they invest in a system and develop increased community based services that include more partial hospitalizations and outpatient programs. This results in services being closer and more accessible to the community, specifically to the families and individuals. He said that he feels that this is a direct result of CST’s work.

David said that reading CST’s reports really allows him to gain a population health perspective in regard to children and families as this is one of the priority populations that DBHIDS is focusing on. DBHIDS is really trying to get a clear picture on how young people are experiencing behavioral health services. The DBHIDS is paying close attention to this area as they are inventing new strategies to transform children and family services. David said that CST reports help to inform the various components that the DBHIDS need to include to develop a more comprehensive infrastructure to support familial systems.

As the DBHIDS moves toward a Population Health approach, particularly prevention as it pertains to family and children, which is David's passion. He says, “Families are the backbone of the community, so as their health goes so does the health of the community. If we can get to them early and in fact keep them well, functional outcomes such as increased high school graduation rates, increased employment and sustained relationships will positively impact families for generations to come!

David believes that CST is better equipped to get the information needed to help develop early intervention approaches because CST obtains information from people that gets to the root cause of issues directly resulting from CST’s ability to develop authentic relationships with individuals and/or families. David feels that herein lays the value of CST as CST brings a naturally relational component to the system and the information gathered really informs because now DBHIDS has the opportunity to use strategies that address the core issues in addition to dealing with the symptoms.

David shared that CST definitely has an impact in developing policy, specifically the inclusion of people with lived experience being involved and employed in all levels of the behavioral health system.

David added that CST is invaluable in circulating information, not only to service providers, but also throughout the community in regard to informing and creating interest in the initiatives that DBHIDS is developing for service recipients and the general public.

During his ten years as Commissioner of the Philadelphia Department of Behavioral Health and Intellectual DisAbilities, Dr. Arthur C. Evans has been vigilant in pursuing his vision of a system that is responsive to individuals’ expressed needs. Dr. Evans feels that his greatest accomplishment over the last ten years is building a system around the idea of recovery and resilience. He feels that promoting recovery and resilience has allowed Philadelphia to organize behavioral health service delivery in a way that has made a positive impact in service recipients’ lives. Dr. Evans says that he has personally witnessed people excelling in roles that were unimaginable to them prior to the transformation of the system and it seems that service providers have also adopted and enjoy working from a recovery standpoint as they get to see those that they work with improve their quality of life. From the DBHIDS standpoint, the department itself has become more effective and efficient because they have embraced recovery. Dr. Evans describes this as a "win- win" situation.

In regard to the Practice Guidelines, Dr. Evans described them as the DNA of the service system. The department brought forth the ideas and concepts and although it has been slow moving, it has been steadily moving forward and has become the standard of how the department conducts business with service providers, with the emphasis placed on ensuring that service providers use Evidence Based Practices, that attention is given to adversity and that the service recipient is connected to the next level of care.

Dr. Evans expressed that CST has an integral role in ensuring that the providers are operating under the parameters of the Practice Guidelines as CST, along with NIAC and Paid for Performance, are interviewing service providers and ascertaining information regarding their utilization of the Practice Guidelines.

Dr. Evans pointed out that CST has a critical role in the system as CST staff speak directly with service recipients and their significant supports persons about their treatment experience and shares this information with the department. Dr. Evans said that historically, the Philadelphia CST has been "remarkable" in their systematic technique of doing in depth interviews with service recipients.

Dr. Evans indicated that over the last several years the current leadership at CST has built on the legacy of CST and has moved forward and embraced the Practice Guidelines and the broader system transformation, which is evident in the way CST handles requests from the department and has executed projects pertaining to specific populations and services. Dr. Evans said, “CST deserves credit… I appreciate the way CST has worked with the department. CST has done everything we asked, and not only done what we asked, but have also gone beyond what was requested!”

A native Clevelander, Sandy Vasko completed her undergraduate degree at John Carroll University in a suburb of Cleveland, Ohio. She spent two subsequent years in New York City, studying at Teachers College, Columbia University to earn her M.A and M.Ed. in Counseling Psychology. She returned home and started her career as a counselor in an inner city methadone maintenance clinic. Within a year she joined the staff of a multi-cultural services center where she functioned in multiple capacities during her eight-year tenure with the agency. During her time as the Clinical Director, she was an active participant on state committees and task forces regarding case management. It was this work that brought her to Philadelphia as a trainer and consultant to the administrative team charged with the closure of Philadelphia State Hospital.

Within a year of starting this work with the newly developing Community Treatment Teams (CTT), Sandy was asked to join the administrative team as the new Case Management Director of CTT, thus started her journey in Philadelphia. She worked with the five state-employed teams for six years to assist in their transitioning into the community and ultimately from a state employment status. With the hospital successfully closed and the teams well established, Sandy was pursued for other growth opportunities with the behavioral health system. In 1996, she was hired as the Health Program Administrator for the Office of Mental Health. Sandy, now the Director for the Office of Mental Health, remains close to those who informed and formed her early experiences in Philadelphia.

Since the beginning, Sandy Vasko has been a believer in the work of the Consumer Satisfaction Team (CST) and an integral part of CST’s accountability process. CST sat down with Sandy to get her perspective of CST’s impact over the last 25 years.

“Twenty-five years, that’s amazing, I just think that’s amazing!” Sandy said that she remembers the beginning because she was brought in as a consultant to the administrative team who was charged with closing Philadelphia State Hospital (PSH). Sandy recalls that it was Estelle Richman (then Deputy Commissioner for Mental Health & Mental Retardation in Philadelphia) basically saying she was always worried with the closing of PSH and things coming up fast and furiously that they were just not going to be any good. Programs were being created and people were moving; there was a lot stuff happening. Estelle was worried that there was going to be a lot of problems because there was no one out there to keep an eye on things. Estelle wanted to make sure that the right things were being done for the right reasons. She wanted something in place to check on the process and ensure that people were satisfied with the services and that people themselves were getting what they needed. She also wanted to make sure that families were satisfied and happy with what was happening with their family member, because there was a lot of family contention that came with the closing of PSH. A lot of people were against the closure, even an individual who became one of CST’s board members struggled with the closing of the hospital in the early days.

Sandy said that Estelle had this notion of putting together this process of consumers and family members. Estelle had known Loretta Ferry, who joined with Mark Davis, and later Valerie Byrd and Marilyn Newmis to form the Consumer Satisfaction Team. This group of people got together and began to talk to people in a very honest, direct, no frill kind of conversation regarding their mental health services and their quality of life. There were no fancy surveys, with ratings one to five, checking boxes, or pat questions… it was a conversation; basic one-on-one conversation and Sandy relayed that she thinks that this is what made CST unique, this is what made CST different and what made it work. It was people asking people, “What do you like about your services? What do you like about where you are living? Are you happy? Are you satisfied?” Sandy said that CST took down literally what the person expressed, no judgments, no interpretations, no reframing and restating. It was honest reporting; whether it was John who needed a new a pair of dentures, Mary who lost her glasses and needed another pair but was told by her insurance company she couldn’t get another pair, to even a staff person who talked about not getting enough training. It was just that ability to capture in the most fundamental way what people had to say; good bad or indifferent.

Sandy thinks that this process worked well and went a distance at the beginning to give the system a feel for what was happening, how things were developing, how things were coming along and if the system was on the right track for what was being done and what they intended on building. However, Sandy said that it was apparent, and probably more apparent to people like Loretta, Mark and Val that somehow there had to be a stronger tie. It was all fine and well to report out and say this is what CST is hearing and learning but if there were issues, concerns or things that needed some answers how did it loop back? How did it assure that the conversation and what was being shared had an importance? That is how the CST accountability meeting started, because CST needed responses from the county. At that point, CST was reporting out to the Office of Mental Health, and with Marilyn Cohen (Administrator of Mental Health at the time), CST began setting up a mechanism where they would meet and would talk about their findings and would basically say to the county that there are a couple of issues here that they would like the county to look into.

According to Sandy, CST matured in terms of adding staff, and growing and doubling in size and moving into new office space. CST and the work took on a different level of importance, not that it wasn’t important from the beginning, but there was a credibility that started to be established. So much so that CST began training other potential CSTs across the country from Maryland to Alaska, and even internationally where people came from as far as England and Israel, to better understand the importance of this thing called consumer satisfaction ascertained by consumers and family members. Sandy believes that CST highlighted the value behind this unprecedented act of consumers and family members teaching other consumers and family members, and more importantly teaching other city governments, about why this is important and why every system should have a CST.

The respect that CST received in all of these various places that they traveled spoke volumes about the basic fundamentals of CST, which is family members and people in recovery out there talking to other family members and people in recovery about their system, because it is their system.

Sandy feels that at this point, the special projects took life. Projects that included the TCM multi-year study, the CRC study, the Recovery House study, and the Forensic study, to name a few. CST provided some very valuable and useful information that has impacted the system and has changed the way some of the providers have done their work. The system has even made some decisions about services and programs based on some repeated issues documented in reports from CST. Sandy said, “CST has been a very influential and, most importantly an informative agent in the system, as CST is able to get information that most entities couldn’t hope to find by using standard survey tools or survey mechanisms. I think the fact that for many, many years CST has held strong to this concept of interviewing people one-on-one, and holding person-to-person conversation serves CST well.”

Sandy continued, “I feel that how CST approaches every visit, with respect and acknowledgement given to provider staff, to provider administration, as well as the people that they serve is why CST has been accepted and where it is today. I think all of that has played into CST’s success. I think that CST really speaks for itself; the people that work at CST have either lived it themselves or are family members to people who are currently living it. Who better to have the emotional investment and the sensitivity to others experiencing the same thing? For me, it’s just a natural fit, and to think that it happened 25 years ago!”

Roland Lamb is the director of OAS, a long time recovery champion, and a believer in the mission of The Consumer Satisfaction Team. He is the esteemed recipient of many awards and accolades, which include but are not limited to, the Dr. Lorraine Hinkle Award for Outstanding Contribution in the Field, Villanova University Continuing Education Program, the Dole Nyswander (Marie) Award conferred by the American Association for the Treatment of Opiod Dependence (AATOD), DRC/Gaudenzia Outstanding Service Award, the Suffering Peoples Award, One Day At A Time (ODAAT), the Faces and Voices of Recovery Vernon Johnson Award, and the 8th Annual Honorable Lucian Blackwell "Guiding Lights in the Community" Award.

In a recent conversation with Roland, he stated, “The DBH is a galaxy with all planets held in a gravitational pull. CST is the comet that flies through uninhibited by the restraints of the system. The galaxy surrounds the person receiving care.” Roland shared that much of what he does at OAS comes from interacting with CST and getting feedback from the site visits and conversations that CST has with those receiving services. He added that OAS has a special relationship with CST as he was first introduced to CST while working as a consultant to Community Behavioral Health (CBH) with Bernie Ferry (the late husband of CST’s first Executive Director, Loretta Ferry). He said, “CST made their bones in the realm of the mental health service arena, and substance abuse was not the focus, but it was sitting on the periphery.” During the conversation, it was made clear that Roland believes that CST is indispensable in relaying the thoughts and feelings of those who receive services.

Roland recalled that when CST first began to visit substance abuse sites the providers didn’t appreciate it and it was his role to talk to the providers and to inform them that it was a priority for CST to gain access to those receiving services within their agencies. Roland added that providers are now more receptive to the value added intervention that is built into the CST process. Roland believes that, “CST is an integral in defining the system and our success in that mission.” Roland further added that there are six ingredients that make the system recovery orientated. They are: reinforcement of the vision/values of the system, high level collaboration and partnerships, assertive community linkages, focused interventions and integrated service delivery. Roland ended the conversation stating that CST is definitely a “recovery champion” and the contribution it makes to the system is invaluable.

IN THE SPOTLIGHT 2011

Loretta Ferry

First Executive Director
The Consumer Satisfaction Team, Inc.

It has been an amazing experience. I wonder now why I hesitated when approached by Marilyn Cohen back in the early summer of 1990. The opportunity to start an agency without any interference from the county office, only their support, was an incredible offer. From the very first day in October we were on our own with only the guidance of a Board of Directors.

Twenty years later we have grown and changed from having the Byberry Class to the entire system. We now have the responsibility of seeking the satisfaction of all who use the Behavioral Health System. And now it is time for me to retire and leave the responsibility in the capable hands of Valerie Byrd and the present Board of Directors.

There are so many people I would like to thank, from the cooperation and support of the Providers to the trust placed on us by the County Office. I know I owe a special thanks to Estelle Richman, whose belief that we would do the right thing has led to our success.

It is not easy saying goodbye to our staff, the very brave people who struggle each day with their own problems in order to help others with theirs. They are a very unique group of people whose lives should inspire us all. They are truly what recovery is all about.

To our Board, thank you for your support, even during the most trying of times.

As I say farewell to all of you, the Board, the system’s people, the providers, our staff, I shall pray that consumer satisfaction lives on. It is important that we seek not the satisfaction of many but satisfaction for all. It is not eighty or ninety percent that we strive to attain. It is one hundred percent.